Examining Physical and Social Environments of Korean American Family Caregivers of Persons Living with Dementia

Abstract Introduction East Asian Americans are considered a hard-to-reach population in the field. Existing resources are not inclusive of Korean family caregivers, and therefore, a community support system may be required for this ethnic group. Methods We conducted a telephone-based survey and in-depth interview with Korean family caregivers of persons with dementia (N=36; Mean age: 63.3) to examine their physical and social environments. Results Most caregivers (58%) co-resided with their care recipients. Those providing care with limited assistance from others showed greater financial hardship (p=0.03) and interference with employment (p=0.03). Job interference was further related to higher levels of caregiving burdens (p=0.01). The services used most were senior center services (25%) and in-home care services (17%), while desired services included health promotion and disease prevention services (50%) and culturally appropriate or medically tailored home-delivered meals services (31%). Caregivers socialized with others using a multi-messaging app (i.e., KakaoTalk) with others. About 74% of them addressed they used KakaoTalk always (52%) or often (22%), and nearly half of them (47%) said they searched for caregiving information online. Findings from our qualitative interviews confirmed positive attitude toward the use of technology. Korean family caregivers showed a lack of knowledge of not only existing community-based resources but also the disease-related information, particularly regarding early-stage support and home safety. Conclusion It is critical to develop a community education program that reflects their unique physical and social environment conditions, potentially through technologically delivered interventions, for outreach and engagement for Korean family caregivers of persons with dementia.

Introduction: East Asian Americans are considered a hard-to-reach population in the field. Existing resources are not inclusive of Korean family caregivers, and therefore, a community support system may be required for this ethnic group.
Methods: We conducted a telephone-based survey and in-depth interview with Korean family caregivers of persons with dementia (N=36; Mean age: 63.3) to examine their physical and social environments.
Results: Most caregivers (58%) co-resided with their care recipients. Those providing care with limited assistance from others showed greater financial hardship (p=0.03) and interference with employment (p=0.03). Job interference was further related to higher levels of caregiving burdens (p=0.01). The services used most were senior center services (25%) and in-home care services (17%), while desired services included health promotion and disease prevention services (50%) and culturally appropriate or medically tailored home-delivered meals services (31%). Caregivers socialized with others using a multi-messaging app (i.e., KakaoTalk) with others. About 74% of them addressed they used KakaoTalk always (52%) or often (22%), and nearly half of them (47%) said they searched for caregiving information online. Findings from our qualitative interviews confirmed positive attitude toward the use of technology. Korean family caregivers showed a lack of knowledge of not only existing community-based resources but also the disease-related information, particularly regarding early-stage support and home safety.
Conclusion: It is critical to develop a community education program that reflects their unique physical and social environment conditions, potentially through technologically delivered interventions, for outreach and engagement for Korean family caregivers of persons with dementia.

FAMILY CAREGIVING AND DEPRESSION AMONG OLDER ADULTS IN JAPAN: A CROSS-SECTIONAL STUDY DURING THE COVID-19 PANDEMIC
Taiji Noguchi, 1 Takahiro Hayashi, 2 Yuta Kubo, 2 Naoki Tomiyama, 2 Akira Ochi, 2 and Hiroyuki Hayashi, 2 , 1. National Center for Geriatrics and Gerontology, Obu, Aichi, Japan, 2. Seijoh University, Tokai, Aichi, Japan COVID-19 infections are particularly lethal in older adults; thus, social activities of older adults and their families in the community have been restricted. The threat of infection, restrictions on social activities, and limitations on the provision of care services for older adults could increase family caregivers' burden and impact their mental health. This cross-sectional study examined the association between family caregiving and change in depression during the COVID-19 pandemic. In October 2020, we conducted a mailed questionnaire survey on a random sample of functionally independent community-dwelling older adults in a semi-urban area of Japan. Based on the depression status between March and October 2020, participants were classified into four groups: "consistently non-depressed," "depression onset," "recovering from depression," and "remained depressed." Participants were assessed for providing care for their family members or not. Caregiver participants were also assessed on their caregiving role (primary or secondary), the severity of their care-recipient's needs, and an increased caregiver burden. Data from 957 older adults were analyzed. The participants' mean age (SD) was 80.8 (4.8) years, and 53.5% were female. Multivariable multinomial logistic regression analysis revealed that family caregiving was associated with depression onset (OR=3.17 [95%CI=1.57-6.40], p=0.001) and remaining depressed (2.53 [1.36-4.71], p=0.004). Particularly, primary caregivers, those providing care for family members with severer care need-levels, and those with an increased caregiver burden had a higher risk of depression onset and remaining depressed. Family caregivers could have severe mental health conditions during the pandemic. Developing a support system is essential to protect their mental health.

HOPE, ACTIVE COPING AND WELL-BEING IN STROKE-SURVIVORS AND CAREGIVERS: AN ACTOR-PARTNER MODEL ANALYSIS Esther Chow, and Sai-fu FUNG, City University of Hong Kong, Kowloon, Not Applicable, Hong Kong
Purpose: Stroke is a medical condition cause of suffering for both patients and their caregivers within the family. This paper aimed to assess the influence of the psychological construct of hope and active coping on hedonic wellbeing in patient with stroke and caregiver dyads by determining the dyadic patterns.
Results: The APIM analysis revealed that both stroke patients and caregivers demonstrated double actor-only pattern. As such, stroke-survivors' hope and active coping excreted an actor effect on their own wellbeing with beta = 0.48 (p < 0.01) and 0.16 (p < 0.01), respectively. Similarly, the caregiver also reported an actor effect between hope and wellbeing (beta = 0.84, p < 0.01) as well as active coping with wellbeing (beta = 0.37, p < 0.01). The overall SEM model also fulfilled the criteria for good model fit (χ2 (5.87), p = > 0.05, CFI = 0.98, TLI = 0.96 and RMSEA = 0.07).
Conclusions: The results suggest that both stroke patients and caregivers' hedonic wellbeing are holding actor-oriented pattern with the hope and active coping. The implications for clinical practitioners, research and theoretical development are discussed.

INNOVATIONS ON DEMENTIA ADVOCACY AMONG STUDENTS OF A MEDICAL UNIVERSITY IN TAIWAN Tsuann Kuo, Chung Shan Medical University, Chung Shan Medical University / Taichung City, Taichung, Taiwan (Republic of China)
In 2017, Taiwan established Dementia Action Plans 2.0 to respond to the World Health Organization's call to increase dementia awareness and support for dementia carers. However, efforts have not yet been made to educate and increase dementia literacy on the younger generations. This paper addressed the outcomes to increase knowledge and information about dementia and caregiver resources to university students. 93 students participated in a two-day workshop on dementia literacy, followed by two months of advocacy in Taichung City, Taiwan. Students were divided into 14 advocacy groups and the outcome reports were categorized qualitatively using content analysis. The results showed that students were from nine departments and over one-quarter having a dementia loved one in the family. Four innovative categories were developed, including (1) dementia literacy for students and the public; (2) dementia friendly action plans; (3) dementia caregiver's advocacy and (4) reducing dementia stereotypes. Highlights included students using social media to promote dementia literacy, face-to-face experiences to inform public education, dementia education on early onset dementia and using diverse bio-psycho-social angels to evaluate dementia. Students expanded advocacy to many social media, innovations and target areas, including Facebook, Instagram, Google spreadsheet, stickers, postcards, illustration of children's books and public announcement. This paper revealed that younger generations used many advocacy methods that were thinking outside of the box. In conclusion, dementia is no longer an elder's business but young adults can bring technological, inter-generational and cultural innovations into fulfilling the goals of Dementia Global Action Plans.

KEY FACTORS IN INTERVENTION IMPLEMENTATION, FIDELITY, AND SUSTAINABILITY
Carey Sherman, 1 Kate Gordon, 2 and Kenneth Hepburn, 3 , 1. Family Care Strategies, LLC,Ann Arbor,Michigan,United States,2. Spilane Consulting,Columbia,Maryland,United States,3. Emory University,Atlanta,Georgia,United States As part of an NIA-supported effort to develop an online course to train individuals to lead the evidence-based Savvy Caregiver program and to orient sponsoring organizations to the program, we conducted semi-structured interviews to assess success and sustainability "best practices". Interviews were conducted with 17 leaders and trainers from eleven Savvy-providing organizations. Analysis of these interviews identified two main themes associated with successful program implementation: leadership commitment and trainer ownership. Paramount to success appears to be leaders' clear understanding of and enthusiastic commitment to the value of the Savvy program to the organization's constituents. This translated to careful selection, training, management and on-going development of Savvy program trainers. It contributed to leaders' appreciation of Savvy as a gateway for clients to seek out other programs and services from the organization, while the gathering of meaningful evaluation data (using established outcome-assessment instruments)